With the ever-present focus on maintaining a healthy lifestyle, patients with established rheumatoid arthritis (RA) struggle between their ideal lifestyle and the limitations inherent to their condition, according to recent research. Patients also described self-regulation when handling lifestyle habits (eg, guilt and motivation), and reported the importance of companionship.

Because little is known about the link between patients’ lifestyle habit experiences and their impact on quality of life in patients with established RA, Karina Malm, PT, PhDc, Department of Clinical Sciences, Section of Rheumatology, Lund University, Sweden, and colleagues conducted a descriptive and exploratory trial using data from the BARFOT (Better Anti-RheumaticFarmacOTherapy) study, a multicenter, longitudinal observational analysis of Swedish patients with early RA. The study comprised 2800 patients aged ≥18 years enrolled between 1992 and 2006. The patients received a mailed questionnaire about lifestyle factors, and interviews were conducted with 22 of the patients.

Feelings of Insufficiency and Self-Regulation

Overall, patients described limitations in physical activity, diet, smoking, and alcohol consumption. For example, limitations associated with physical activity were related to joint pain, stiffness, and fatigue. These limitations led patients to feel that a sense of insufficiency was affecting their quality of life because they were not able to walk or perform certain activities; however, patients tried to adapt to these situations to continue remaining physically active.

Self-regulation—including guilt and motivation when performing lifestyle habits—also influenced patients’ quality of life. Patients may experience guilt, for example, if their diet was unbalanced, or when family and friends gave their opinion about the diet they should be following. Motivation was observed among patients who wanted to change their diet and improve their quality of life. Similar observations were seen for physical activity, smoking, and alcohol consumption.

The Importance of Companionship and Belonging

Companionship, including the sense of belonging and pleasure when performing lifestyle habits, was another factor that impacted quality of life in patients with established RA. In particular, patients who smoked got the sense that they belonged with other smokers, and described experiencing pleasure when smoking, which impacted their quality of life. Interestingly, a similar sense of belonging was seen in patients who did not smoke, and who experienced pleasure from not being exposed to smoke, the investigators noted. This was also seen in terms of alcohol consumption, where patients described a feeling of belonging that had an impact on their quality of life, as well as experiencing pleasure by eating and drinking in social situations.

“The patients experience a struggle to determine the right balance of lifestyle habits in order to enhance quality of life and to try to achieve a normal life, independent of the established RA,” Ms Malm and colleagues concluded. “This is important new knowledge for health professionals when discussing lifestyle habits with RA patients.”